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BACKGROUND: While new HIV diagnoses in the United States have declined overall, diagnoses among men who have sex with men (MSM) have not. Engagement in HIV care, which leads to reduced transmissions and better clinical outcomes, has not been characterized for this subpopulation in New York State (NYS). We assessed linkage, retention and viral suppression among MSM by age.
METHODS: Linkage to care (newly diagnosed only), any care, retention in care, and HIV viral suppression in 2012 for persons in the NYS HIV surveillance registry were estimated using laboratory data routinely collected by NYS Department of Health and following Centers for Disease Control and Prevention’s (CDC) methodology. Males aged ≥ 13 years living with diagnosed HIV infection as of December 2012 with MSM or MSM with injection drug use risk were selected for analysis. The number of HIV infected MSM in NYS was estimated using NYS and CDC estimates of the proportion of persons unaware of their infection. Subgroup prevalence ratios (PR) and 95% confidence intervals (CI) were computed.
RESULTS: An estimated 58,201 MSM in NYS were living with HIV infection at the end of 2012; of these 10,069 (17.3%) were undiagnosed. HIV diagnosed MSM were predominately white (38%) and middle aged (median 47 years). The percents with any care (67%), retained in care (58%), and virally suppressed (56%) were comparable to the total NYS population living with diagnosed HIV infection (65%, 56%, 51%, respectively). Of 1,781 newly diagnosed MSM, 87% were linked to care within three months of diagnosis; median age at diagnosis was 30 years. Linkage was lower for young MSM (13-24 years; 83%) than for those age ≥25 years (88%) (PR 0.94 (95% CI: 0.90-0.98)). Retention in care was not significantly different between younger (60%) and older (58%) MSM (PR 1.03 (95% CI: 0.99-1.08)), but viral suppression was significantly lower (44%) in the younger group than in older cohorts (55%) (PR 0.79 (95% CI: 0.74-0.84)).
CONCLUSIONS: Linkage, retention and viral suppression among MSM in NYS were comparable to those of other risk groups overall. Similar to national reports, linkage and viral suppression were significantly lower among young MSM. This is important because in contrast to all other groups, new HIV diagnoses have increased among young MSM in the last decade. Targeted interventions are needed to improve linkage and viral suppression among young MSM.